Journal of Psychiatry

Reducing Stroke Risk in Patients with Atrial Fibrillation, Minimally Invasive Clipping of the Left Atrial Appendage: A Case Series Report

Donna Eaton^* Mater Misericordiae University Hospital, Ireland
^*Correspondence: Donna Eaton, Mater Misericordiae University Hospital, Ireland,

Published: 16-Sep-2020

Abstract

Introduction: There is a clear relationship between the left atrial appendage (LAA) and stroke in patients with non-valvular AF. Recently, device closure of the LAA has emerged as a safe and effective alternative to anti-coagulation for some patients. We present our experience of minimally invasive clipping of the LAA.

Results: We have performed thoracoscopic occlusion of the LAA using an epicardial clip (AtriClip) in 15 patients. LAA clipping was performed as a stand-alone procedure, a hybrid procedure (in combination with catheter based ablation), part of a totally thoracoscopic AF ablation procedure or as an adjuvant in patients undergoing left thoracoscopic operations (e.g. lobectomy, lung biopsy). The clip is deployed epicardially over the base of the LAA under direct vision, effectively and reproducibly occluding the LAA.

In all cases the clip achieved complete LAA exclusion. It can be easily deployed via a minimally invasive surgical approach requiring only a short (30-45 minute) general anesthetic. We have found minimally invasive LAA closure to be a safe, reliable and well-tolerated procedure.

Discussion: Unlike endocardial devices this method allows immediate cessation of anticoagulation medications, as the clip is placed epicardially there is no requirement for anticoagulation post deployment and no risk of complications related to device migration.

Biography:

Donna Eaton is an internationally trained thoracic surgeon who was appointed at the Mater hospital Dublin in 2013. She has extensive experience in minimally invasive surgery including thoracoscopic and robotic surgery. Since taking up practice in Ireland, she has expanded the range of minimally invasive surgical approaches and specialist procedures offered to patients in the Republic of Ireland.

Speaker Publications:

1. Riddell Peter, Kleinerova Jana, Eaton Donna, Healy David, Javadpour Hossein, McCarthy Jim, Nölke Lars, Redmond Karen, Egan Jim. (2020). “Meaningful survival benefit for single lung transplantation in IPF patients over 65 years of age”. European Respiratory Journal.

2. Kehlet H, Wilmore DW. “Evidence-based surgical care and the evolution of fast-track surgery”. Ann Surg 2008; 248:189–983.

3. Schatz C. “Enhanced recovery in a minimally invasive thoracic surgery program”. AORN J 2015; 102:482–92.

4. Das-Neves-Pereira J-C, Bagan P, Coimbra-Israel A-P et al. “Fast-track rehabilitation for lung cancer lobectomy: a five-year experience”. Eur J Cardiothorac Surg 2009; 36:383–92.

10th International Conference on Neurological disorders & Stroke; Webinar-August 21-22, 2020.

Abstract Citation:

Donna Eaton, Reducing stroke risk in patients with atrial fibrillation, minimally invasive clipping of the left atrial appendage: A case series report, Stroke Congress 2020, 10th International Conference on Neurological disorders & Stroke Webinar- August 21-22, 2020.

(https://stroke.neurologyconference.com/abstract/2020/reducing-stroke-risk-in-patients-with-atrial-fibrillation-minimally-invasive-clipping-of-the-left-atrial-appendage-a-case-series-report)